OBJECTIVES: The aims of this study were to evaluate changes in plasma superoxide dismutase(SOD) activities in alcohol depedence, to fine out variables to influence on the SOD activities, and finally to identify the correlation of SOD activities with the alcohol-associated cognitive disorders. METHODS: For 24 male alcoholics and 21 healthy male controls, plasma SOD activities were measured by spectrophotometry on 1-2 wks after alcohol withdrawal. Structured interviews and laboratory tests were also performed. RESULTS: 1) Upon comparing SOD activities between controls and alcoholics, the SOD activities were significantly(p<0.01) lower in alcoholics(0.308+/-0.140 units/mL) than in healthy controls(0.313+/-0.086 units/mL). 2) Upon comparing SOD activities according to the presence of alcohol-related cognitive disorders, the SOD activities were significantly(p<0.05) lower in alcoholics with cognitive disorders(0.247+/-0.049 units/mL) than in alcoholics without cognitive disorders(0.317+/-0.148 units/mL). 3) Upon comparing SOD activities according to the presence of alcoholic polyneuropathy or alcohol withdrawal seizure, the SOD activities showed no significant differences between alcoholics with polyneuropathy or epilepsy and those without. 4) Upon analyzing variables influencing on the SOD activities in alcoholics, the SOD activities had the negative correlation with hemoglobin(gamma=-0.433) and severity of alcohol withdrawal symptoms(gamma=-0.375). 5) Upon comparing variables according to the presence of alcohol-related cognitive disorders, the occurrence of alcoholic polyneuropathy(p<0.05) and blood phosphorus concentrations(p<0.01) were significantly higher in alcoholics with cognitive disorders than those without. 6) Upon analyzing an association between SOD activities and variables in alcoholics with cognitive disorders, the SOD activities were positively correlated with the onset age(gamma=0.995), and negatively correlated with the severity of alcohol withdrawal symptoms(gamma=-0.996). CONCLUSIONS: Lower SOD activities in alcohol dependence suggested alcohol-associated cognitive disorders and alcohol withdrawal symptoms might be caused by oxidative stress.
Alcohol Withdrawal Seizures ; Alcoholic Neuropathy ; Alcoholics ; Alcoholism ; Epilepsy ; Humans ; Male ; Oxidative Stress ; Phosphorus ; Plasma ; Polyneuropathies ; Spectrophotometry ; Substance Withdrawal Syndrome ; Superoxide Dismutase* ; Superoxides*

OBJECTIVES: The aims of this study were to discriminate the clinical differences, to measure the estrogen and homovanillic acid levels. to evaluate a correlation between estrogen and homovanillic acid. and to identify an association of cognitive deficit with estrogen and homovanilli acid among male and female schizophrenics. METHODS: In addition to the structured interviews, the plasma estrogen levels by radioimmunoassay and the homovanillic acid levels by HPLC were measured in 20 male and 21 female schizophrenics as well as 10 healthy male and 9 female controls. RESULTS: 1) The plasma estrogen levels were higher in females than males, and significantly higher in female schizophenics than female controls. The homovanillic acid levels were higher in female schizophrenics than female controls, and were lower in male schizophrenics than male controls. 2) The onset age seemed to be earlier in male schizophrenics, and the frequency of admission, duration of antipsychotic drug administration. dosage of antipsychotics and duration of illnesses were more in males. The estrogen and homovanillic acid levels were significantly higher in female schizophrenics. 3) The estrogen levels had a significant positive correlation with sex, age and onset age, while the homovanillic acid levels did with sex. However, estrogen wee not correlated with homovanillic acid levels. 4) The estrogen and homovanillic acid levels were not significantly different between male and female schizophrenics with cognitive deficits. In the schizophrenic patients without cognitive deficits, the estrogen levels were significantly higher in females, while here were no significant sex differences in homovanillic acid. 5) In the male and female schizophrenics predominantly with negative symptoms, there were no significant differences in estrogen and homocanillic acid levels. In those predominantly with positive symptoms, the estrogen levels wee significantly higher in females, while there were no sex differences in homovanillic acid levels. 6) In schizophrenics with undifferentiated subtype, the estrogen and homovanillic acid levels were significantly higher in females. In those with paranoid or disorganized subtypes. the estrogen levels were significantly higher females, while there were no sex differences in the homovanillic acid levels. 7) The mean values of PANSS-negative. PANSS-total, PANSS-CF, MMSE-K and estrogen levels were significantly higher in male schizophrenics with cognitive deficits. The mean values of illness duration, CGI PANSS-positive, PANSS-negative, PANSS-total, PANSS-CF and MMSE-K were significantly higher in female schizophrenics with cognitive deficits. 8) The variables which showed significant correlation with cognitive deficits were PANSS-nagative, PANSS-total, PANSS-CF, MMSE-K and estrogen levels in male schizophrenics. The variables which showed significant correlation with cognitive deficits were subtypes, onset age, illness duration, CGI, PANSS-positive, PANSS-negative, PANSS-total, PANMSS-CF and MMSE-K in female schizophrenics. The estrogen levels were significantly correlated with admission frequencies, history of antipsychotic administration, duration of antipsychotic administration and cognitive deficits in male schizophrenics. while age were not correlated with in females. The homovanillic acid levels had a significant correlation with subtypes and onset age in male schizophrenics, while there were no correlation among variables in females. CONCLUSIONS: Although the plasma concentrations of estrogen and homovaillic acid in female schizophrenics were significantly higher than males, we could not find an association between them. Furthermore, the various factors affecting on the cognitive deficits, estrogen and homovanillic acid levels seemed to be somewhat different according to sex.
Age of Onset ; Antipsychotic Agents ; Chromatography, High Pressure Liquid ; Dopamine* ; Estrogens* ; Female ; Homovanillic Acid ; Humans ; Male ; Plasma ; Radioimmunoassay ; Schizophrenia* ; Sex Characteristics

OBJECTIVES: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. METHODS: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. RESULTS: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. CONCLUSIONS: Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.
Anxiety ; Consciousness ; Delirium ; Diagnosis ; Humans ; Inpatients* ; Medical Records ; Mood Disorders ; Substance-Related Disorders

No abstract available.
Suction* ; Tonsillectomy*

OBJECTIVES: Chronic alcohol consumption has been known to result in various neurocognitive deficits. Many neuropsychological studies revealed that the major disturbances occurred in the executive function learning and short-term memory. visuospatial performance function, perceptuo-motor skills and abstraction and problem solving abilities. This study was done to identify which cognitive areas might be mainly affected. METHODS: The cognitive disturbance was evaluated using the Korean Version of the Mini Mental State Examination(MMSEK) and the 7 Minute Screen(7MS) in male inpatients with alcohol dependence(N=31) as well as in age and education level matched healthy male controls(N=30) Four individual tests of the 7MS were consisted of the Benton Temporal Orientation Test the Enhanced Cued Recall, the Clock Drawing and the Category Fluency. RESULTS: 1) The average scores of four individual test of the 7MS for the alcoholics were 2.77+/-4.38 for the Benton Temporal Orientation Test. 13.90+/-2.02 for the Memory Test(the Cued Recall 6.77+/-1.94, the Uncued Recall 7.10+/-2.45), 5.84+/-1.86 for the Clock Drawing and 12.58+/-3.29 for the Category Fluency. Except the Benton Temporal Orientation Test, there were statistically significant differences between test scores of alcoholics and those of controls(p<0.01). 2) The alcoholics who had MMSE-K score<24 were 9.68%. The average(+/-S.D) score of the MMSE-K for the patient group(27.23+/-2.62) was significantly(p<0.001) lower than that of the healthy controls(29.20+/-1.24) There were no statistically significant differences between four individual test scores of the 7MS of alcoholics with the MMSE-K score<24(N=3) and those of alcoholics with the MMSE-K score > or =24(N=28) 3) Four individual test scores of the 7MS seemed to have statistically significant association with such variables as MMSE-K, duration of alcohol drinking blood magnesium concentration liver function and thyroid function. CONCLUSION: Mild deficits of cognitive areas such as orientation, memory, visuospatial abilities and verbal fluency could be found in alcohol dependence.
Alcohol Drinking ; Alcoholics* ; Alcoholism ; Education ; Executive Function ; Humans ; Inpatients ; Learning ; Liver ; Magnesium ; Male ; Mass Screening* ; Memory ; Memory, Short-Term ; Problem Solving ; Thyroid Gland

OBJECTIVE: The continuous synthesis and degradation of proteins in the cell are essential for the maintenance of cellular homeostasis. Intracellular protein degradation largely occurs in the lysosome and cytoplasm. The protein degradation in the cytoplasm (ubiquitin mediated protein degradation) is distinct from the well studied lysosomal protein degradation (nonselective protein degradation) and require energy (ATP), ubiquitin and ubiquitin conjugating enzymes such as E1, E2 and E3. Dementia caused by the deposition of abnormal proteins in brain cells followed by brain cells damage are not fully understood. To better understand the possible mechanism of dementia, we attempted to purify ubiquitin conjugating enzymes (such as E1 and E2 proteins) from the blood of normal persons and patients with dementia and tested their electrophoretic mob)ility on SDS-polyacrylamide gel electrophoresis. METHOD: The E1 and E2 enzymes of the red blood cell lysate fraction from the normal person and the patients with dementia were purified from ammonium sulfate precipitatant of DEAE-cellulose eluate fraction. Following ubiquitin-sepharose column chromatography, the E1 enzyme of the normal and the patients with dementia group showed homogeneous form and various kinds of E2 isoforms were identified by the SDS-polyacrylamide gel electrophoresis. RESULTS: The E1 and E2 enzymes showed no difference on electrophoretic mobility, but the E2 isozyme containing fraction was observed to great difference between the two groups. The 44 kDa protein of E2 isozyme containing fraction was significantly increased in alcoholic dementia and clearly increased in patients with Alzheimer's disease. In addition, another 11 kDa protein was significantly increased in the patients with Alzheimer's disease, but 11 kDa protein of alcoholic dementia was similar to that of the normal person. The 44 kDa and 11 kDa proteins showed a reverse relationship between alcoholic dementia and the patients with Alzheimer's disease. These proteins seems to be different molecules from the well known studied beta-amyloid, presenilin, tau protein and apolipoprotein E (Apo E). CONCLUSIONS: These results might be useful for the elucidation of dementia and the identification of these proteins are now in progress.
Alcoholics ; Alzheimer Disease ; Ammonium Sulfate ; Apolipoproteins ; Brain ; Carrier Proteins* ; Chromatography ; Cytoplasm ; DEAE-Cellulose ; Dementia* ; Electrophoresis ; Erythrocytes* ; Homeostasis ; Humans ; Lysosomes ; Presenilins ; Protein Isoforms ; Proteolysis ; tau Proteins ; Ubiquitin* ; Ubiquitin-Conjugating Enzymes

BACKGROUND: The purpose of this study was to find out what factors affect revisits by elderly patients to the emergency department (ED) with the same symptoms within 72 hours and hospitalization after a revisit. Delineating these factors can reduce unnecessary revisits to the ED and minimize problems with diagnosing and treating, improving the quality of treatment provided and of discharge decisions. METHODS: This is a retrospective study involving 3790 elderly patients who presented initially to a general hospital ED between May 1, 2007 to June 30, 2009. Of these, 176 cases revisited the ED within 72 hours with the same symptoms. Their medical records were reviewed. A comparative analysis was conducted of the early revisit group by classifying them into 'discharge' and 'admission' considering age, gender, insurance status, means of arrival, chief complaint, diagnosis, length of stay, time of arrival, comorbidity disease, time lapse, and day of the week. RESULTS: The factors affecting revisits were age (< or =79 years), insurance status (medical aid), means of arrival (walk-in), and chief complaint (dysuria.flank pain, skin rash). The factors affecting hospitalization after a revisit were age (> or =80 years), means of arrival (by ambulance), increasing length of stay, and high comorbidity index (> or =2). CONCLUSION: The factors affecting revisits to the ED or hospitalization after a revisit were age, insurance status, means of arrival, chief complaint, length of stay, and comorbidity index. Physicians should be more careful when deciding discharge for elderly patients, especially those with the above factors.
Aged ; Comorbidity ; Emergencies ; Hospitalization ; Hospitals, General ; Humans ; Insurance Coverage ; Length of Stay ; Medical Records ; Retrospective Studies ; Skin

No abstract available.
Bacteriology* ; Biliary Tract*

PURPOSE: Atrial natriuretic peptide(ANP) is a hormone with strong vasodilating, diu-retic and natriuretic properties. The aim of this study was to clarify the interrelationship of ANP secretion and hemodynamic changes of patent ductus arteriosus(PDA) in healthy preterm and fullterm infants without clinical evidence of PDA. METHODS: Thirteen preterm infants and six full term infants who did not develop clinical evidence of PDA were studied at 6 hr, 12 hr, 24 hr, 3rd day and 4th day after birth, until their PDAs closed spontaneously. Plasma ANP concentrations and the hemodynamic changes of PDA were rneasured. RESULTS: The ANP concentrations of all infants increased from 34.1+/-10.9 pg/ml at 6 hr to 120.5+/-18.8 pg/ml at 12 hr, and declined thereafter gradually to 74.2+/-12.7 pg/ml at 4th day. The ANP concentrations, LA/Ao ratio and LAV decreased after ductal closure. The pulmonary flow velocity(PFV) of PDA correlated with ANP concentration in preterm infants(r=0.23, P<0.05). LA/Ao ratio correlated with ANP contration in all infants (r=0.28, P<0.05), especially in preterm infants(r=0.46, P<0.01 during 12 hr and 4th day after birth. LAV correlated with the ANP concentrations in preterm infants during 12 hr and 4th day after birth(r=0.34, P<0.05). CONCLUSION: The changes of ANP concentrations are probably due to the changes of the left-to-right shunt of PDA with left atrial stretch. Reduction of the ANP concentrations may serve as an indicator of spontaneous closure of PDA. Therefore ANP measurement may be useful in deciding the need and the timing of medical and surgical managernent of newbom infants without clinical evidence of PDA.
Atrial Natriuretic Factor ; Ductus Arteriosus, Patent* ; Hemodynamics* ; Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Premature ; Parturition ; Plasma*

OBJECTIVE: Stenotrophomonas maltophilia has been emerging as an important nosocomial pathogen in recent years in patients with impaired host- defense mechanism or who has been exposed to large amount of inocula. This organism is usually resistant to multiple (commonly used) antimicrobial agents, particularly to those of the beta-lactam class. To evaluate the clinical feature of Stenotrophomonas maltophilia infection and in vitro anti- microbial susceptibility, we performed a retrospective study. METHODS: We analyzed the result of in vitro antimicrobial susceptibility test for 200 isolates of S. maltophilia and the annual isolation rate during the period between January 1990 and December 1994 in our institution, and performed a retrospective study for the available records of 165 cases among them. The data were obtained with only the first isolation of the organism for each patients. RESULTS: Total of 165 initial isolates, the isolates were from wounds in 50(30.3%), urine in 47(28.5%), the respiratory tract in 37(22.4%), blood in 9(5.5%), bile in 6(3.6%), and miscellaneous sources in 16(9.7%). The 84.2% of isolates were hospital-acquired isolate and 58.3% of these patients had received antecedent antibiotic therapy: polymicrobial growth was demonstrated in 61.9% of the cases. In vitro antimicrobial susceptibiiity test, ofloxacin was active against the isolates in 89.2%, moxalactam in 85.9%, ciprofloxacin in 83.9%, TMP-SMX(trimethoprim-sulfamethoxazole) in 64.2%, As expected, S. maltophilia isolates were, in general, not susceptible to cephalosporins, penicillins. The annual isolation rate at Kyung Hee University hospital was not increased significantly from 1990 to 1994, 19.53 per 10,000 patients dismissals in 1990, 13.56 in 1994. The major underlying diseases of patients were malignancy(17.6%), cerebrovascular disorder(17%), diabetic mellitus(13.3%). Mortality rate is 10.3%. CONCLUSION: S. maltophilia has been emerging as an important nosocomial pathogen in immunocompromised patients, especially those receiving broad-spectrum antimicrobial therapy. And this organism is resistant to multiple antimicrobial agents, particularly to those of the beta-lactam class. When antimicrobial treatment is necessary, the clinician should be guided by results of in vitro susceptibility testing because of the notable in vitro resistance of S. maltophilia to commonly used antibiotics. And when S. maltophilia has been recovered from a patient, wound and contact isolation is warranted.
Anti-Bacterial Agents ; Anti-Infective Agents ; Bile ; Cephalosporins ; Ciprofloxacin ; Humans ; Immunocompromised Host ; Mortality ; Moxalactam ; Ofloxacin ; Penicillins ; Respiratory System ; Retrospective Studies ; Stenotrophomonas maltophilia ; Stenotrophomonas* ; Wounds and Injuries